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It’s the first time the court has considered the question of insurance reimbursement for medical marijuana.

Madawaska resident Gaetan Bourgoin won a ruling from the state’s Workers’ Compensation Board two years ago saying the paper mill’s insurer must reimburse him for medical marijuana. He contends marijuana is cheaper and safer than narcotics.

But Twin Rivers Paper Co. and its insurer appealed the ruling, arguing that paying for cannabis use, even for medical purposes, could expose the companies to prosecution since marijuana still is illegal at the federal level.

“Opioids are killing people every day in Maine.”

Justice Donald Alexander, Maine Supreme Judicial Court

With medical marijuana legal in Washington, D.C. and 29 states, insurers across the country have been confronted with the same dilemma. Uneven state laws on reimbursement further complicate the issue.

Five states — Connecticut, Maine, Minnesota, New Jersey and New Mexico — have found medical marijuana treatment is reimbursable under their workers compensation laws, according to the National Council for Compensation Insurance. Florida and North Dakota, meanwhile, passed laws this year excluding medical marijuana treatment from workers’ compensation reimbursement.

Members of the Maine Supreme Judicial Court posed hypotheticals to the attorneys arguing the case. One asked Bourgoin’s attorney what he’d do if a client needed cocaine for pain treatment, and another asked Twin Rivers’ attorney whether she believes the federal government will start prosecuting insurers for medical marijuana reimbursement.

Justice Donald Alexander repeatedly questioned whether marijuana use should remain illegal under federal law and contrasted the drug with opioid-based painkillers, which he said drug companies have lobbied Congress to protect.

“Opioids are killing people every day in Maine,” he said.

Bourgoin’s case dates to 1989, when he hurt his back as a 29-year-old at the paper mill now known as Twin Rivers.

Twin Rivers attorney Anne-Marie Storey said paying for medical marijuana puts the company in violation of federal law. The company contends that Maine’s medical marijuana law does not explicitly require an insurer to cover the cost of medical marijuana.

“This is not a case about making judgment over whether someone should use or not use marijuana as a matter of personal choice,” she said. There’s a scarcity of research on medical marijuana, and “nobody knows” how safe it is, she said.

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